How can I check a doctor's professional history?

July 15, 2005 5:52 PM

Can anyone help me find out about my New York City based doctor's professional history in greater depth?

Am facing major surgery this week and am trying to check out my doctors. I've looked in the AMA site (basic info), HeathyGrades (costs $7.95 for info about any past disciplinary actions taken against a doctor but not about lawsuits taken out against doctors). The NY State Department of Health site has listings of professional misconduct and physician discipline but also no malpractice lawsuit info.

posted by nickyskye to health & fitness (12 comments total)

Three things:

1. Most states, accreditation organizations, and licensing boards don't list info about times someone has been sued, since the fact that someone has been sued doesn't mean anything about whether that person did anything wrong. (For example, it's not that rare for every single doctor who has written in a medical chart to be named in a lawsuit about an occurrence during that hospitalization -- and I mean every generalist, every specialist, every resident, every intern, every anesthesiologist, every radiologist, everyone.) Given the low bar to being named in a lawsuit, it's a disservice to list that information as if it has some intrinsic value, and most groups who'd track the information recognize that. (And that's not even mentioning how difficult it would be to even know when someone's named, since there's no requirement to notify, say, the American Board of Pediatrics or the NY State Medical Licensing Board when you're named in a lawsuit.)

2. Have you seen the NY State Physician Profile site? It compiles the info that the state does recognize as being relevant markers of physican performance.

3. Have you thought to just ask your doctors? I can't speak for everyone, but I know I've been asked by patients before, and given that I understand that they're interested in whether or not I'm OK to take care of their children, I take no offense to the questions.

Good luck with your surgery!
posted by delfuego at 6:55 PM on July 15, 2005

I think the simplest thing is to ask him/her about the questions you have--I am not sure exactly what it is you want to know--since he is doing surgery he has privileges at the hospital(s) where he practices--you certainly can ask him/her for a copy of the material submitted to request privileges--this would give you a sense of his professional history and credentials--it is much like a CV and should be readily available. I can't imagine why it would need to be confidential--malpractice history is dicey--I think the only fair thing to ask him is if he has had any malpractice awards or settlements in the last five-10 years--suits or allegations in themselves may not be a good indicator. I hope your surgery goes well--BTW--do not understimate the importance of the hospital and surgical team--your surgeon is only one part of the effort--I would want to know the reputation of the hospital--particularly how many of your procedures they do vis a vis other institutions--the more the better--remember--the anaesthesia and post op recovery (including possibility of infection) are probably riskier than the surgery itself--
posted by rmhsinc at 7:06 PM on July 15, 2005

delfuego, excellent link. Via that site I got my surgeon's license number and can lnow ook him up on the NY State Department of Health site. Thanks.

The horror stories I've heard about NY doctors and experienced a few myself (including being told I had a tumor and when I looked in the file there was no mention of a tumor, went for a second opinion and no tumor) make it uncomfortable to ask a doctor what their record is like and how many would answer honestly "Yeah, I'm a lousy doctor and have botched a number of surgeries." ?

I was part of a focus group once naming a blood 'adhesive' (Bioplast) for brain surgeons who made a mistakes in surgery (yikes, lol) it was a kind of blood bandaid. It was one of those moments when I thought it might be wise to check up on a doc's history of mistakes, if they were documented.

I did ask my doc straight and he said he's performed this surgery between 600 and 700 times, including when he was a student. That was encouraging, since he's had his license 9 years.

rmhsinc, I want to know does this surgeon have a decent hand, does he have people ticked off with him for bad surgeries?

So the question to the doc would be: "May I have a copy of the material submitted to request privileges at the hospital where he practices? Is that how to phrase the question to him?

I don't want to antagonise him by asking if he had any malpractice awards or settlements in the last five-10 years. the last time I had surgery (in the Netherlands) the doc was livid when I asked questions. Some docs (way too many in my experience) don't like patients with questions, at all.

Good question about the rep of the hospital. Any idea how I would go about finding out about Lenox Hill hospital? How would I find out particularly how many of these procedures they do vis a vis other institutions?

You're right about the anesthesiologist and post op recovery, I totally agree they are important and have no idea how I'd find out about any of the players involved. I will ask the name of the oncologist who will co-perform the surgery and Google him as well. I can ask the name of the anesthesiologist and Google him/her but have no way of knowing about the post op team.

If it were Sloan Kettering I know I'd be in better hands but my insurance isn't accepted there.

In any case, thank you both for your information. It's been very helpful.
posted by nickyskye at 9:51 PM on July 15, 2005

This is purely anecdotal, but I had abdominal surgery at Lenox and everyone was wonderful. How did you find this doctor in the first place? Was he highly recommended? Were you a referral from another doctor? I'm sorry to hear you have to go through this-- I hope you're better soon. Feel free to email me if you have any questions, I've had surgery at Lenox, Columbia Presbyterian, and North Shore.
posted by astruc at 10:00 PM on July 15, 2005

nickyskye, sounds as if you have had some experience s that could be unsettling--Yes, you can pose the question as stated to the physician or his/her staff--it is a legitimate though unusual request. I honestly think the best thing to do is to directly express your anxiety/fear to your physician or their PA and indicate you need some objective reassurance, not just about the surgery in general, but their specific competence. You should expect a bit of defensiveness but be firm. I work with a number of physicians and find it interesting that when they need medical services they have some of the same anxieties as you and struggle to make decisions. Often their decisions are complicated by professional relationships, not wanting to hurt a colleagues feelings, etc. Sometimes the simplest and most reassuring thing to do is to go to a large teaching hospital where they do a high volume of the procedures you are having ( is this possible with you insurance). Regarding the specific hospital--I do not have an easy answer--I would call their public relations/information department and make a specific request for the information. My Best wishes
posted by rmhsinc at 4:00 AM on July 16, 2005

astruc, Thank you for your kind offer of private email. So far I feel very satisfied with the answers here. Great news you had a good experience at Lenox. The doctor I'm seeing was referred by a radiologist/oncologist out of a list of docs who take my insurance. He works out of Lenox. He seems like a good guy, certainly the best communicator of any doctor I've met and listened when I had preferences. I'm inclined to go with him but wanted to be diligent in checking up his his professional history.

I honestly think the best thing to do is to directly express your anxiety/fear to your physician or their PA and indicate you need some objective reassurance, not just about the surgery in general, but their specific competence. You should expect a bit of defensiveness but be firm. I work with a number of physicians and find it interesting that when they need medical services they have some of the same anxieties as you and struggle to make decisions. Often their decisions are complicated by professional relationships, not wanting to hurt a colleagues feelings, etc.

Thanks rmhsinc. Solid advice and reassuring that doctors themselves have these kinds of anxieties.

Sometimes the simplest and most reassuring thing to do is to go to a large teaching hospital where they do a high volume of the procedures you are having ( is this possible with you insurance). Regarding the specific hospital--I do not have an easy answer--I would call their public relations/information department and make a specific request for the information.

Again, good, practical advice, but of course a hospital's pr department would, naturally, sell itself as great, however they would have figures on how many of these procedures they do a year.

This is something I really wanted to talk about: the teaching hospital. I like this doc, he's performed this surgery 600 to 700 times but not spefically for cancer, which I have. He'll be working with an oncologist in the operating room. Why is a teaching hospital better? Googling teaching hospitals in NYC, I found out that Lenox is, in fact, a teaching hospital, which I didn't know before.

Once again, thank you very much for your advice and information. This is a critical moment in my life and it's a time when every bit of info helps.
posted by nickyskye at 8:15 AM on July 16, 2005

Ask a lot of questions. What are they doing? What's going to happen? Ask enough questions to be sure you understand all you want to know about it (some people don't really want to know much, they find it unsettling.) Most surgeons will almost automatically reassure you why this or that bad thing is not going to happen to you, and they know what bad things can happen better than you do.

You'll have to trust the surgeon on the anesthesia, the surgical team and the post-op, to a certain extent. They can make or break him, and he's not going to work with people who do him or his patients harm or that he doesn't trust.

If you've had a bad experience, the right thing to do is tell him. They need to know what you're worried about and why, and they'll try to make you feel better about it, and besides it's really part of your medical history, if you want to think of it that way.

I understand why you might not wish to question the guy's credentials to him, but they all have papers framed on their walls that have useful information on them. You should look for things that have to do with his specialty, and then you can look up what they mean on the 'net. All of this is of course in addition to any other research you wish to do. If they have something like "1-800-doctors" in your area, those phone lines often have all their credentials listed and will read them to you. Some of the hospitals also have a similar service for the surgeons who practice there.

Best of luck, we all wish you well, and will worry about you.

On Preview: I wasn't going to mention the nice guy thing, but I always go with the nice guy. Good communicators are hard to come by in some fields. I always figure the nice guy probably is really a nice guy, and that they have a certain kind of personal ethics, if you will, that they live up to their own personal standards. It sounds like you're in good hands.
posted by deep_cover at 8:23 AM on July 16, 2005

I've always been uncomfortable with the notion that "teaching hospitals are better" -- what's better about most "teaching hospitals" (I keep putting it in quotes because it's a very vague notion, more on this later) is the fact that the focus of the care is as much around the academics and training as it is the outcome. Note that that's not to say that the focus on outcome is somehow lessened, but rather, that the entire hospital is built around the idea that better training of all levels of medical practitioners -- medical students, nursing students, physical therapists, medical and surgical interns, clinical residents and fellows, clinical aides, nurses, nurse practitioners, junior attendings, senior attendings, the whole works -- provides better care and outcomes for today's patients and tomorrow's patients.

What comes out of the environment of most teaching hospitals is generally a culture of evidence-based practice (i.e., studies show that A works better than B), empiric testing of ideas (i.e., running a carefully-designed study to compare treatment A to treatment B), and quicker access to modalities of treatment that have been recently demonstrated to be better for patient care. The science that goes on within the walls of most teaching hospitals (and by that, I mean people working with beakers, chemicals, cells, and centrifuges, not patients) contributes to the culture of rigorous scientific testing of hypotheses before exposing actual people to those hypotheses, and extends into the clinics in that clinicians continue to revise hypotheses and improve on care by observing patient experiences using the same rigorous methods.

As for the notion of "teaching hospitals," you'll find that the term is as vague in practice as it sounds, and there are certainly gradiations in the scale. Using New York hospitals as examples, there are places like New York-Presbyterian, NYU, Mt. Sinai, and Einstein/Montefiore, all of which are pretty much as academic and teaching as you can get -- you can't throw a bedpan without hitting someone training for a career in the medical field, and literally, as a patient, you can accidentally wander into a lab building and find yourself surrounded by -80 degree freezers, centrifuges, and shelves full of beakers. Then, there are places like St. Luke's/Roosevelt and Lenox Hill, which are primarily clinical facilities that are strongly tied to academic institutions. Not much, if any, actual basic or translational science goes on at those places, but trainees rotate through them for their clinical experience, and the senior staff is made up of people who are on the academic faculty of the major training facilities. And lastly, there are community hospitals (places like Nyack Hospital come to mind) that are, for the most part, established community doctors who are less involved in day-to-day academic medicine.

While I can't imagine that that cleared anything up, I hope it makes some sense!
posted by delfuego at 8:50 AM on July 16, 2005

Delfuego: great analysis--I read so many medical blogs (etc) I lose track--but a article recently struck home--all things considered the best outcomes are where there is the highest volume of like procedures and where that it is "teaching hospital" even better--Don't know New York @ all but for me that means the Cleveland Clinic and University of Michigan Hospital if I am not positive about local resources. If I was having a sophisticated procedure that is critical I definitely would pay the difference in fees for in and out of "network" but I am very fortunate to have that option. Nickyskye--Let us know what you decide and how it goes--My Best to you
posted by rmhsinc at 10:08 AM on July 16, 2005

Ask a lot of questions. What are they doing? What's going to happen? Ask enough questions to be sure you understand all you want to know about it (some people don't really want to know much, they find it unsettling.)

deep_cover, that's reassuring. Am one of those people who feels unsettled NOT knowing, having paid dearly for not knowing with other doctors before. I will ask lots of questions in a non-adversarial way. Need to formulate them before seeing the doctor again. It will help to think of them in the calm of my apartment, I lose my clarity in the doctor's office. It helps to look at the overview and plan this out.

If you've had a bad experience, the right thing to do is tell him. They need to know what you're worried about and why, and they'll try to make you feel better about it

and

I understand why you might not wish to question the guy's credentials to him, but they all have papers framed on their walls that have useful information on them.

Excellent points.

I'm concerned that he knows how to do this surgery when cancer is involved and will have to rely on the oncologist who will also be in the operating room. Through research I found out I need to ask if this oncologist is a SURGICAL oncologist in case certain veins need to be tied off etc that are not part of the non-cancer surgery. I think once I know more about the oncologist, if he's experienced in this surgery, I'll feel more comfortable or else seek the surgery elsewhere.

but I always go with the nice guy. Good communicators are hard to come by in some fields. I always figure the nice guy probably is really a nice guy, and that they have a certain kind of personal ethics, if you will, that they live up to their own personal standards.

Yes, the ethics and character of the doctor are very important to me when dealing with a medical situation. I met a person in the CAT scan waiting room this week who called their first oncologist "the axe murderer", lol, saying this doctor not only was obnoxious to communicate with, unreliable and inaccurate but put all the hospital staff on edge with his rages and it was profoundly unsettling to be around in weakened health, feeling powerless physically post surgery.

A doctor who expresses their good character with decent communication and listens to/is able to answer questions is a gem.

Thank you for your thoughtful reassurance and well-wishing. I really appreciate it deep_cover.

you can't throw a bedpan without hitting someone training for a career in the medical field

delfuego, thanks for the bellylaugh.

And thank you for the superbly articulated description of teaching hospitals. Your info made excellent sense and clarified a lot for me. From what you said it would seem that a teaching hospital is by far the best choice of a hospital.

I am wrong that Lenox Hill is a teaching hospital, it's "a major teaching affiliate of NYU Medical Center", which is, "tied to academic institutions" but not a teaching hospital.

Is there a teaching hospital in NYC that you recommend?

rmhsinc, I agree with your opinion of delfuego's post, thank you for your opinion and especially your well-wishing. Much appreciated.
posted by nickyskye at 11:02 AM on July 16, 2005

Recommending hospitals in NYC is tough for me, since I'm a pediatrician by training, and pediatrics training is pretty much as separate from adult facilities as you can get. That being said, the biggies in NYC are New York-Presbyterian (note that that's actually two hospitals from the perspective of the patient, New York Hospital and Columbia Presbyterian) and NYU; at any of those, you'll be right in the thick of academic training, and all three facilities are highly regarded, both in terms of academia and patient care. But the super-specialization of NYC medicine is as much a part of the difficulty as anything else -- for example, New York Eye and Ear is fabulous at what it does, but obviously limited in what it does. In the same vein, I've heard that Lenox Hill is outright terrific at bariatric surgery -- so while it's not an academic hospital in the purest of senses, it's particularly good at certain things.

Probably the best recommendation I can give you is to enlist the help of your general practitioner in finding the right place for you. Ask him or her to comment on the pros and cons of each hospital for the specific surgery you're facing, and talk it through. In the end, though, you just have to feel comfortable that the place you've chosen will do everything in its power to give you the best outcome possible, and that it has the resources to make that happen.
posted by delfuego at 12:24 PM on July 16, 2005

delfuego, another excellent post. Many thanks!
posted by nickyskye at 1:58 PM on July 16, 2005